1. Field of Invention
This invention relates generally to surgical drapes, more particularly to a surgical drape which isolates the limb upon which surgery is to be performed from the rest of the body, and specifically to such drapes which are adapted to circumferentially envelop a patient's extremity during the operative procedure.
2. Description of Prior Art
Surgeons commonly use the technique of irrigation and debridement on contaminated, or dirty traumatic wounds or on bone fractures which penetrate the skin, prior to closure of such wounds. Irrigation is a thorough cleansing of a wound with a saline solution or other sterile irrigants. Debridement is the removal of foreign matter such as dirt or grass, or removal of dead and devitalized tissue from the wound. The purpose of wound irrigation and debridement is to remove foreign matter or dead tissue from the wound and to decrease the amount of bacteria in a wound prior to closure. This in turn decreases the chance of infection in the wound.
Historically, when surgery is to be performed on a patient's extremity, it has been standard procedure to drape the entire patient with folded linen sheets, yet leave the extremity that is to be operated on accessible and free, so that it can be manipulated in the desired position. This is accomplished by allowing one nurse to elevate the limb while the surgeon and an assistant position drapes under and over the extremity, thereby covering the torso. In this way the prepared surgical limb was said to be "draped free" from the rest of the body, so as to isolate the prepared surgical limb from the rest of the body. Recently, fenestrated surgical drapes are used to isolate the surgical limb. The prepared limb is passed through the fenestration in the drape, and in this manner, the surgical limb is exposed for surgery while isolating it from the remainder of the body.
Once the surgical limb has been draped free, a collection pan is then placed under the wound on the limb, in order to collect the sterile irrigation fluids used during irrigation and debridement. Irrigation and debridement of the wound is then performed using pressurized irrigation solution, either from a hand syringe or from tubing with a nozzel tip. During irrigation, a significant amount of the solution will splash from the limb onto the surgeon, nurse and assistants. Also the pan placed under the limb will not catch all of the irrigation solution, and some of the solution will spill onto the floor as well as the surgeon's and nurse's feet. The splashed or spilled irrigation fluid becomes contaminated by the patient's blood during irrigation. If the patient has a blood borne viral disease such as AIDS, Hepatitis A, B, or C, or Cytomegalovirus, then the surgeon, nurse, or assistants may be at risk for contracture of these diseases through the splash or spillage of the contaminated irrigation fluid.
The prior art has been directed to covering limbs (such as legs) to isolate a surgical area other than the limb, from the limb itself in order to prevent contamination from the unprepared body to the prepared surgical extremity. This has been accomplished recently by the use of nonwoven liquid repellent disposable drapes. Some of these drapes have fenestations through which the prepared limb is placed in order to isolate said limb from the rest of the body. Examples of patient extremity drapes of this type may be found in U.S. Pat. No. 4,957,120 to Grier-Idris (1990), and 4,119,093 to Goodman (1978). These fenestrated drapes provide a barrier only between the prepared limb and the rest of the body. They do not provide any splash of spill barrier to the surgeon or assistants.
Tubular extremity drapes made of an innerstockinette material and outer liquid proof film are also used to isolate the surgical limb from the rest of the body. Examples of this type may be found in U.S. Pat. Nos. 3,540,441 to Collins (1970), 3,707,964 to Patience and Collins (1973), 3,769,971 to Collins (1973), 3,777,749 to Collins (1973), 3,934,582 to Gornie (1976), 3,968,792 to Small (1976), 3,989,040 to Lofgren and Farrow (1976), and 4,308,864 to Small et al (1982). These tubular extremity drapes, once in place must be then cut open to gain access to the limb prior to irrigation and debridement. Once cut open, the drape is not resealable, the irrigation solution can splash, and a collection pan must be used to collect the irrigation solution. Also, these tubular extremity drapes do not create a fluid resistant seal at the open end.
For gynecological or obstetrical procedures, prior art devices have included a drape having seperate leggings or seperate leg drapes. In all of these patents, the object or area of surgery is other than the extremity which is draped. Examples of these drapes may be found in U.S. Pat. Nos. 3,494,356 to Melges (1970), 3,613,676 to Endres (1971), and 3,693,618 to Madden (1972).
While the previously mentioned inventions are effective in creating a liquid imprevious barrier between the prepared surgical extremity and the rest of the body, they suffer from major distinct disadvantages:
(a) None of these surgical drapes provide a barrier to the surgeon or assistants to splash of contaminated irrigation fluids.
(b) None of these surgical drapes provides a fully enclosed liquid resistant system to collect and drain contaminated irrigant fluids.
(c) None of these surgical drapes provide a slit to provide access to the limb, which is resealable to recreate a fluid splash barrier for further irrigation.